More articles, for what they're worth.
How Europe, After a Fumbling Start, Overtook the U.S. in Vaccination
Just a few months ago, European Union efforts were a mess, but its problems were temporary. The United States turned out to have the more lasting challenge.
Vaccine Effort in Europe Pivots to the Underclass
Across the continent, reaching vulnerable populations on the margins of society is a challenge. In Brussels, the authorities are hoping mobile outreach teams can help.
Germany Will Offer Vaccine Booster Shots Starting in September
In rich countries, the momentum is growing for giving additional doses to the fully vaccinated, though many experts say the focus should be on getting first doses to people around the world.
Pfizer and Moderna raised their vaccine prices in their latest E.U contracts.
The U.S. finally hits its 70 percent vaccination goal — four weeks late.
States with low vaccination rates are seeing more people seeking out the shots as the Delta variant creates a new wave of cases.
Hundreds of health workers in isolation as Delta hits Australian state of Queensland
Outbreak forces millions into lockdown in the sunshine state as New South Wales races to administer 6m doses amid Covid surge
China authorities to test all Wuhan’s 11 million residents amid new Covid cases
Eight cases reported in city where coronavirus first emerged in 2019
Walter Isaacson interviews Michael Osterholm ...
Michael Osterholm is the director for Infectious Disease Research and Policy at University of Minnesota. [Here he is] speaking to Walter Isaacson ...
Isaacson: I'm down here in New Orleans. Like much of the country, we're fighting the delta variant that's come along. With that delta variant, it [sprang] up in India and raged through the country and then subsided. And it seems it is doing the same in England. Is there a chance that variants like this just burn themselves out?
Osterholm: One of the observations we've had with COVID-19 and SARS-CoV-2 specifically, the virus, is it seems to want to run sprints and not marathons. And what I mean by that is we have a whole overlapping set of these kind of whack-a-mole sprint moments country by country. Just this past week, Iran is in its fifth surge and reporting the highest numbers of cases it has since the beginning of the pandemic. I can go country by country, region by region and show you the same thing, that without regard to necessarily what the humans do, you will see these big surges of cases often lasting 5 to 8 weeks, and then it just ends, even though there [is] still, as I say, a lot of human wood for this coronavirus forest fire to burn. And then it starts back up again later. ...
Isaacson: You just said it surges and then recedes, irrespective at times of what humans do. Does that mean that we should just all get vaccinated, but not worry quite so much about shutdowns and mask mandates?
Osterholm: Well, first of all, again, we have to look at what can we really do about the virus? Clearly, if we are not in contact with others, we're not going to get infected not we're going to transmit the virus. So, distancing can play a key role regardless of whether the virus is going to do its sprint or a marathon.
I have had concerns and I -- it dates back to April of 2020 about the concept of masking. Needless to say, it's a political hot button beyond anything I've ever seen in public health. And yet, at the same time, I think we've all done a disservice to the public. When you actually look at face cloth coverings, those cloth pieces that hang over your face, they actually only have very limited impact in reducing the amount of virus that you inhale in or exhale out.
And in fact, studies that have been done show that if an individual might get infected within 15 minutes in a room, by time and concentration of the virus in the room, if you add a face cloth covering, you only get about five more minutes of protection.
And so, I've been really unfortunately really disappointed with my colleagues in public health for not being more clear about what can masking do or not do. On the other hand, if you use the N95 respirators and you fit them tight to your face, you can actually spend 25 hours in that same room and still be protected.
Isaacson: But we're not going to all be using N95. I mean, I got my mask here. With a Saints logo on it. I mean, it seems that we can't just do that.
Osterholm: Well, you know, it's not about what you can and can't do. The science is first. And then we have to understand, then you can decide what you can and can't do. The bottom line, though, is by telling people that, in fact, just putting a face cloth covering on is going to protect you is just simply not true. So, when you ask what can you do if you don't want to put N95 on or you feel like you can't, then that is your choice, but bottom line is, putting your face cloth covering is only going to provide you limited protection.
The same is true how you wear it. We've been doing surveys on television screen shots of news media events looking at how many people are wearing a face cloth covering or a mask or whatever, but then more importantly, how do they wear it? 25 percent of the population consistently, since the beginning of the pandemic, wore it under the nose. That is like fixing three of the five screen doors in your submarine. You know, it's just ridiculous. If you're going to wear, actually wear it to try maximize your protection.
So, we can do something about it. Distancing works. Efficient and effective respiratory protection works and most of all, vaccine works. So, there is a lot we still can do.
Isaacson: If we have protection against serious illness, even if the virus starts to spread, isn't that going to help solve this if enough of us just don't get all that sick if the virus spreads and it is a little like a mild case of the flu?
Osterholm: You know, that is a critical point. I'm quoted in the New Yorker article posted yesterday, just that very piece. About the fact that we have to understand how much we've still gained from these vaccines. It's been remarkable in the reduction in the number of deaths. And if you look at England, if you look at Israel, that is the case.
The one thing, however, we have to be very careful of again, and this is again trying to see into the future. Every morning, the first thing I do, I get up and try to scrape the four inches of mud off my crystal ball and then go to work.
And in this case, if we look at what's happened in Israel, what they have found is a rather rapid reduction in the prevention to get serious illness after six months. So, even there we're seeing now this wane in immunity having impact on whether you get serious illness or not, which is all the reason why you're going to keep hearing much more in the days ahead about booster doses.
That's why the Israelis have now initiated booster doses for those over 60 years of age and those who have underlying immune conditions. And I think that's what's going to happen here. Then we may be able to maintain the high level of protection against serious illness and death, which by itself would be a tremendous gift in terms of fighting this virus.
Isaacson: You've mentioned social distancing. How realistic is it today to get us back to social distancing? Does it mean we have to try to do shutdowns again?
Osterholm: Well, first of all, when we talk about social distancing, we have to understand that today it has a different meaning than it did at the beginning of the pandemic, when people thought it was just a six-foot distance, that ... it was transmitted via what we call respiratory droplets, those kinds of boulders that come out of our mouths and our nose when we speak or cough or sneeze, and they fall within six feet of us.
Today, that is not the science that we know. We know these are transmitted with aerosols. If you want to know the difference, all those plexiglass plates you saw that were put up that supposedly separated you from me with six feet have no real purpose today at all. The aerosols, to understand really, are, the best way I can tell people to do it, if you are in a room with someone and they are smoking and you smell it, you are getting basically inhaled aerosols in.
Walking down the street, you know, I just had this happen to me this past weekend where all of a sudden, I smelled cigarette smoke and I looked around and I was downwind from somebody 20 feet from me on the side of the sidewalk smoking. And now, in that case, you wouldn't likely get infected from just that exposure. It's a time concentration. But we now have evidence that with the delta variant in particular, it may [be] just a few minutes of exposure before you get infected.
So, when I say social distance, I'm talking about you do have to be apart from someone sufficiently that you wouldn't smell their cigarette smoke.
Now, that is a lot longer than six feet in most cases. So, what does that mean? Well, it means everybody can't do that.
We don't have that much space in the world and people aren't going to do it on mass transit. They are not going to do it in grocery stores, et cetera.
So, then I say well, well, how likely is it if you get infected you might have a very serious illness? Are you older? What is your body weight? Do you have underlying immune deficiencies or immune suppression because of the drugs you are taking or health condition you might have?
And then I say, you don't want to be around people any period of time without an N95 respirator on and in fact, that distance. So, I don't think it is going to apply to the general public. It just can't happen. It won't happen. And that is the challenge we have today.
Isaacson: Are you concerned about recent studies that that show cognitive problems of people who have had COVID?
Osterholm: I don't think anyone really understands the legacy of COVID-19 well into generations ahead. I think the issues around long COVID or long-haulers is going to be a very substantial issue. And I think the cognitive disfunction is going to be part of it. I think that there is going to be much, much more coming from this fight between our bodies' immune systems and this virus and what it's done to all the rest of our body.
You know, we're like a castle that has been taking incoming from this virus and then we've fought back. And in the process, we both did damage to our castle. And so, I think that this is a challenge. And I do worry a lot about these long hauler-like conditions, which cognitive dysfunction is one of them.
Isaacson: Do you think it would be a good idea just to push as hard as we possibly can to convince and in some cases nudge people to get vaccinated and forget about all the other peripheral stuff that we don't even quite know if it works?
Osterholm: Well, I think, again, vaccine is at the very foundational aspects of anything we do to change this pandemic. Let me just say though, I've been in this business 46 years. I have spent my career promoting vaccines. I actually helped write the legislation here in Minnesota back in the 1980s to mandate vaccines in institutions or higher education. You know, I have been in the forefront of this. And I've never seen anything like this before.
Please do not tell me lessons ... learned from childhood immunizations and apply them here, because they just don't apply. This is a different situation. We have three groups of people today. They are the vaccine-affirmative. These are the people that drove 120 miles in February snowstorms to find vaccine in a clinic in some remote town. They couldn't wait to get it.
Then we have the vaccine-hesitant. The group that, at this point, they have still legitimate concerns. This isn't a licensed vaccine. I am a pregnant woman. I am a member of the black community who's been experimented upon by government. And this was operational warp speed and it is not a licensed vaccine. All really legitimate questions.
And then there is the third group. The vaccine-hostile. These are people who under no conditions will be vaccinated, at least, in any way against their will. And they are a group that in many cases don't even believe the pandemic is real, et cetera. The vaccine-hostile, we're never going to get.
You know, whatever they have to do to not get vaccinated, they will do it.
It's the vaccine-hesitant right now that we need to really focus on and convert those people to vaccine recipients. And we're actually making progress there. And, you know, the more information we get on the vaccines in terms of licensure I think is going to help a lot.
You know, we do have stops and starts. In the last 72 hours I've take a number of questions from people who said, wait, wait, wait. No. Why would I get this vaccine now? Because I can still transmit the virus? And so, you know, we have to go through all of it, just lay out why this is still a very important tool, what that means. But I think the vaccine- hesitant group, that if we can bring them along, that is going to be a group that will be very important.
Isaacson: I want to you look into the camera and give a great one- sentence pitch to a vaccine-hesitant person.
Osterholm: If you don't care about yourself, you can say, I don't [need?] this vaccine. I'm strong enough. But if you care about the ones you love, your friends, your family, your colleagues, your mother and father, grandfather, your kids, you will get this vaccine.
Isaacson: Should restaurants require vaccines?
Osterholm: I would say every place right now. I do that. I, for example, though I have not supported a vaccine mandate at our own institution, the University of Minnesota. And the reason for that is because in Minnesota law, the way vaccine exemptions are set up in our public institutions, you have to offer deferments for medical reasons and for philosophical reasons. So, all I have to do is sign a sheet of paper and say, I'm done, I'm not getting it. Have it notarized, and I'm exempt.
And if we put a mandate in place today, we have heard from some of those very communities I just mentioned, the black community, said, if you mention the word mandate we're done. We're out. We're going to sign off. We're not going to get it. We need time to bring these people along.
Remember, this isn't a campaign like we used for childhood immunizations, where it may take us years before we're able to get vaccine levels up.
Look at, even in adults with vaccines like shingles or HPV, how long it's taken us to get people to actually take the vaccine. Here we're now expecting in just a few months for that to happen. If we put in place a mandate in our state, in colleges and university, we're going to see a lot of people sign that exemption and we'll never get them back, and those are the ones who we're trying to get on board.
So, I think there is a time and place for mandates. I have to say, you know, when I started here in Minnesota back in the mid-1970s, it was at the heyday of the Indoor Air Act and clean air. And we heard from bars and restaurants around the state, oh, my God. If you put in place non-smoking, we're done. We're cooked. We can't make it. Well, it turned out people had forgotten that 30 percent of smokers were very different than 70 percent of people who didn't smoke, and they couldn't wait to get to a bar or restaurant that was actually smoke-free, and business went up.
And so, I think right now if you had restaurants and bars, you had venues where people required to be vaccinated and show that, that you would actually see participation substantially increase beyond anything else. I'd feel safe to go there today. I wouldn't feel safe to go to a restaurant today where that wasn't the case.
Isaacson: The music venues here in New Orleans have all just decided to say, you need to show on your phone your vaccine -- you know, that you're vaccinated, whether it's Preservation Hall or DBA or Tipitina's, and that's caused an uptick in people getting vaccinated. They want to go hear music.
Does that make sense?
Osterholm: I think that's -- I love that. I think that's the incentive piece. You know, there are two ways to go at this. There's vinegar, and there's honey. And you know, wherever you can use honey, we've shone in public health time and time again. It's the most effective way to go.
Isaacson: You say that the single most important thing we can do to protect our health in face of this virus is to get vaccinated. What about children, young children?
Osterholm: Young children right now are a challenge. We have to acknowledge that. We need to get vaccine for those children. You know, these studies can't get done quick enough.
But also, Walter, you know, one of the challenges I have, and I don't know what the answer is, and this is one of those issues of humility, is the fact that here we are talking about the riches of the high-income countries are debating whether to have a booster dose, a third dose and we have 6.4 million people living in low- and middle-income countries and less than 2 percent of them had access to any doses. And, you know, we can surely make an argument on the humanitarian basis, the critical need to get vaccine to the countries.
But also in a very important way is the fact that these new variants are not as likely to come spinning out of a smaller population experience like the United States. But they surely could spin out in large numbers in these infections among the 6.4 billion people living in low- and middle-income countries. So, it is in our strategic interest to get vaccine to these countries just to try to preserve and protect the integrity of our vaccinations today.
So, you know, I think we have lot of work to do, as I've said. And from your perspective as a historian and expert in this, we need a Manhattan Project now to make vaccines. We need a whole lot of Marshall Plans to get it delivered.
Isaacson: And do you think very young children, they should be authorized now to be vaccinated?
Osterholm: I don't think the data are there yet to provide the satisfactory safety information that [is] going to be required. We're going to have a hard time getting parents to buy this vaccine for their kids for a number of them. Some parents can't get it quick enough. But there are going to be a lot of parents that I've seen, the kind of communications from these patients, that say, no way are my kids going to get vaccinated. They are not going to be an experiment.
And so, again, this is going to be our challenge, is, we're going to have schools where some kids will be vaccinated and some kids won't. We have to anticipate that now. What can we do now to help basically provide the support, the education, the information.
The other thing, I think, that's happening that is a game changer, is in the first year of the pandemic, right up through the time when the alpha variants really started to emerge, we did see a very different epidemiology of infection in kids. It was much less infectious. Kids did not transmit nearly as readily between themselves or others, or did they get infected? We didn't see nearly the same spectacular (?) of serious illness. That all changed with alpha. And now, with delta, it's even been accentuated.
And so, I think that one of the things we have to understand is that the data we had a year ago on kids and infection doesn't hold up today. And the data today says kids are [at] a lot higher risk of getting infected, of transmitting the virus, and potentially even having serious illness.